One of the early milestones in my public health career was -with others – to succeed in having the Rothmans tobacco company banned from continuing to use the comic actor Paul Hogan (later of Crocodile Dundee fame) in Winfield advertising. It had been the biggest and most successful tobacco advertising campaign in Australian commercial history and we ended it overnight.

Because we had no money, the campaign we ran was conducted in the news media. The newsworthiness of what we were attempting was a re-telling of the David and Goliath moral tale. I quickly became a media and political go-to person for tobacco control.

I soon realized that advocacy for policy change and changing the way that health issues were perceived both publicly and politically was accorded very little analysis in research nor training in public health education. I set out to try and upgrade the academic respectability of both.

So in 1991 I established and started teaching what was only the world’s second university course unit in public health advocacy (I believe the first was started at Berkeley in California by Larry Wallack and Lori Dorfman). The unit was offered at the University of Sydney’s School of Public Health in the Masters of Public Health degree. It became immensely popular, with non-degree students flying in over the years from Iceland, UK, Spain, Netherland, New Zealand, USA, Canada, China, Singapore, Indonesia and all round Australia. Since my retirement in 2014, it has been taught by Becky Freeman who has specialised in advocacy and social media.

I published two text books for the course in 1994 and 2006 which are still returning sales royalties. In the 30 years between 1991-2021 I ran advocacy training courses and sessions in 14 countries on all continents but South America.

My course was primarily focused on media advocacy and gave particular emphasis to understanding news values, framing and reframing, news routines and cultures and the importance of strategic planning of media advocacy, rather than just instinctively running at the mouth when an opportunity presented itself. Researchers typically carefully plan and rehearse conference presentations they might give to 100 people in a room. But few plan interview strategy when given an opportunity to speak to sometimes millions on national television, including politicians able to make a needed policy change.

Problem-based learning

Over the years I’ve had many requests for teaching notes on public health advocacy.  Below is an outline of the approach  I took to both teaching and assessment.  I hope you will find it useful in your own teaching and staff development.

After a day of lectures and inspirational talks from public health advocates and journalists, our in-class discussions for a full day of the course were problem-based. I wrote trigger scenarios based on actual or hypothetical “this is happening now” problems. Here are five examples


A glossy booklet is distributed by  a transnational liquor company has to every doctor, politician and mass media outlet in your country. The main message is that alcohol advertising does not influence aggregate (total) demand for alcohol and that restrictions on advertising beyond those which currently exist are unjust and unwarranted. The booklet also details the company’s history of commitment to funding rehabilitation and responsible drinking education programs.


The new Unit established within the government to examine ways of reducing the effect of regulation on business activity publishes a report that shows that 95% of the population claim never or seldom to read grocery content labels; and that 99% of those sampled could not name any of the food additives corresponding to the numbered system on a randomly chosen set of common grocery items. The report recommends that content and additive labelling be made voluntary, arguing that the present system is an unnecessary and costly burden to industry which serves little purpose.


The Health Minister issues exemptions allowing tobacco sponsorship for an international  women’s golf tournament. The program will feature an internationally renowned golfer, who having had breast cancer, is a prominent advocate for breast screening. She will donate 10% of her winnings to the national breast cancer campaign.


The local government of a suburb three kilometres from the central business district of your city announces that a deal is to be struck with the state government to use a large, long-disused ugly factory site as a car park linked to the city by a light rail system. The scheme will take 5000 cars out of the city and provide lucrative rental revenue to the local government. The site for the car park is in the middle of a high density, low income residential area. There are no parks or open spaces in a two kilometre radius of the site. A local resident group (which has an active core of about 10 people with another 40 or so who sometimes help out with local projects) wants the site to be turned into a recreation park for local residents.


A right wing popularist politician is elected to parliament on a platform that includes reviewing the Family Court to investigate why women are awarded child custody far more than men. It will also take evidence from men accused of domestic violence to their partners who believe they have been “set up” and not given a fair hearing in the Family Court. The politician names three leaders of a “men’s action network” who he says should be on the review.

Students would select one such scenario (or write their own) and then work in small groups across the day to answer the following questions, which were then presented and discussed with the full class.

  1. WHAT DOES THIS SCENARIO MEAN TO PUBLIC HEALTH? What are the possible adverse consequences for public health that arise from this scenario? (ie: why is it of concern?) THEREFORE, WHAT ARE YOUR PUBLIC HEALTH OBJECTIVES? Define your public health objectives: what do you want to achieve by any advocacy initiatives you might take in response?
  • WHAT ARE THE PRINCIPAL SUB-TEXTS OF YOUR OPPOSITION’S POSITION HERE? What values and strengths do these bring to your opposition’s position (and by implication, what do these suggest about anyone like you who opposes this position?) Think about how this might need to be addressed in your planned strategy.
  • DO YOU BELIEVE THAT A MEDIA ADVOCACY STRATEGY WILL BE CRITICAL TO ACHIEVING YOUR PUBLIC HEALTH OBJECTIVE? What changes in public or political awareness and attitudes do you want to achieve via a media advocacy strategy?
  • ACCESS & FRAMING STRATEGIES: What creative initiatives are likely to both give you maximum coverage (framing for access) and frame the issue in ways that will advance your goals (framing for content)? Are there any analogies that might be used which will assist in your framing efforts? Brainstorm. Don’t stop at one or two – you can always discard the less brilliant ideas later! Are there IMAGES, METAPHORS, AND “PAINTING A PICTURE” STRATEGIES you can utilise here to good effect?’
  • CREATIVE EPIDEMIOLOGY/STRATEGIC RESEARCH: Are there “killer facts”, perspectives and comparisons that you would like to use in your response? Where might you obtain these if you haven’t got them?
  • MEDIA BITES: A reporter phones. He/she wants a comment from you about this issue. Frame a “media bite” (about 30 words or 15 seconds) that will advance your goals. If you have time, come up with several.


In every year I taught the MPH course, I set the same two choices of assessment questions (below)

  1. Collect all press cuttings (try the Factiva database) you can gather or TV or radio tapes on a current public health issue. Analyse the media coverage of this issue for the dominant sub‑textual themes, rhetorical devices and ideologies that make this issue newsworthy. Discuss possible implications of the way this issue has been “framed” for public health policy and practice.


2. Select a current public health problem which is being either neglected or adversely framed by the media. Analyse the likely reasons why this subject is attracting the press (or lack of press) it currently suffers. Outline (and argue for) an advocacy strategy designed to re‑frame this issue in such a way that it will attract media and/or political attention more conducive to advancing it in a positive direction vis a vis public health.

Suggested length up to 2000 words (more if you want, but much less than 1500 will probably mean you have prepared a reasonably superficial treatment).  NB: Do not spend more than a couple of paragraphs describing the epidemiology or impact of the problem you select. This essay is NOT about how well you can describe a health problem, but about how well you can understand how it is or is not being depicted in the media as a health issue, and what you might do to change or further this.

I was privileged to read many highly sophisticated papers and over the years to see many course graduates go on to become potent advocates across a wide range of public health issues.

This paper, which highlights 10 cardinal lessons for public health advocates and young researchers, may also be useful.